The living environment of individuals with self-neglect is usually messy. The living conditions can be assessed by asking the following questions:

Is the home livable, or habitable?

Is pest-control needed?

Is animal-control needed?

Is there hoarding that is dangerous?

Are there any public health hazards?

A city inspector checking a hot water heater

Habitability

Homes must pass basic city inspections in order to be lived in. This usually includes at a minimum:

Running water,

Functioning utilities (e.g. electricity, gas, water),

Functioning toilet,

Lighting, and

Heating (City of Houston, 2013).

Houses that have not been maintained will require the needed repairs or the house may be condemned. Adult protective services will assist the adult as needed.

Pest-Control and Animal-Control

Pest-control may be required if there are infestations. Individuals with self-neglect may also hoard animals, such as cats or dogs, but they may not provide adequate food, water, or shelter. Animal urine and feces may be found in the house.

Talking therapy is a common treatment for hoarding

Hoarding

Hoarding commonly occurs in individuals with self-neglect. This may result in fire and safety hazards. Items may fill rooms to the point that the bathroom and kitchen can no longer be used. Professional cleaning services may be needed to haul away all of the items. Individuals cannot live in a house that is a known fire hazard.

Hoarding itself can be difficult to treat. Talking therapy is the most useful treatment for most individuals. See Hoarding for more information.

Public Health Hazards

In some cases, the individual may seek help only when threatened with eviction or having their house condemned (McGuire, Kaercher, Park, & Storch, 2013). This increases the individual’s chances of becoming homeless (Hoffman, 2013). At times, self-neglect may become a public hazard, such as in cases where the clutter poses a fire hazard. Treatments may include:

In order to live in a house, it must meet certain standards

Adult Protective Services,

Home care services,

Professional cleaning services,

Exterminator services,

Legal services if threat of eviction,

Animal control,

Cognitive behavioral therapy, and

Law enforcement authorities may be required (Dobrian, 2015).

Rights of the Hoarder

Fair Housing Act

In May 2013, mental health guidelines began listing hoarding as a separate disease from obsessive-compulsive disorder (American Psychiatric Association, n.d.). As such, hoarding disorder is now classified as a disability under the Fair Housing Act (Ligatti, 2013). Property owners cannot simply demand that the hoarder fix the problem or move out. They must reasonably accommodate individuals with disabilities, including hoarding. Although legal action is rarely required, the resident may consider advice from a housing lawyer in complex cases. Usually property owners will work with the resident to control the hoarding behavior so that it does not present a danger or a general nuisance (Dobrian, 2015).

Limitations of Code Enforcement

No single governmental agency addresses compulsive hoarding , instead multiple agencies must working together to solve the problem (Ligatti, 2013; Gibilisco, 2016). Code enforcement agencies have a role in cases of hoarding to maintain clean, safe and healthy environments (Gibilisco, 2016). However, the code enforcement officer must observe a clear danger in order to act (Sacramento County Code Enforcement, 2017). When violations occur, code enforcement officers will advise the occupant to decrease clutter, clean up unsanitary conditions, and remove any potential fire hazards (Shenfil & Thurston, 2015).

Code enforcement agencies have the authority to step in and force a cleanup of a property without the consent of the owner

Constitutional Protection

There are laws that prevent government personnel from performing inspections of private property unless permission is granted by the property owner (Gibilisco, 2016). The Fourth Amendment protects people from unreasonable searches and seizures, and a warrant needs to be issued for a search (Fourth Amendment, US Constitution, n.d.). For example, a code enforcement officer cannot demand that he or she be allowed to search the house for evidence of a fire hazard. However, if there mounds of clutter that can be seen through an open front door that may indicate a present danger, the code enforcement officer can request a search warrant from a judge (Gibilisco, 2016).

Power of Code Enforcement

If the individual does not voluntarily address code violations and the home remains a danger to the individual and/or community, code enforcement agencies have the authority to step in and force a cleanup of the property without the consent of the owner (Flaglerlive, 2013). If the code violations cannot be addressed, the house may be condemned.